(6 of 10)
Not until the present century did it become clear that safe blood transfusions depended on matching at least the A, B and O groups of red cells. The Rh factor came still later. In the early 1900s, U.S. Physiologist Charles Claude Guthrie and French Biologist-Surgeon Alexis Carrel appeared for a while to have broken down the barriers against transplants. They devised most of the basic surgical techniques, notably how to stitch slippery little blood vessels together so that the joints would neither leak nor close down with clots.
Guthrie grafted a second head onto a dog half a century before the Russians did it in 1959. Carrel kept part of a chicken's heart "alive" in a laboratory flask. But they still could not get organ grafts between two animals to take for any length of time.
The full explanation of one man's rejection of another's flesh had to wait until 1953, when Britain's Sir Peter Brian Medawar revealed details of the immune mechanism involving the white blood cells. These are the body's main line of defense against viruses, which have protein coatings, and against many other germs. They react just as strongly against any "foreign" (meaning another person's) protein. They make antibody to destroy such invaders.
Spare Kidneys. This explained why the first few kidney transplants, begun at Boston's Peter Bent Brigham Hospital in the early 1950s, had failed. It also explained the success of Dr. Joseph E. Murray's first transplant of a kidney between identical twins, done at the Brigham in 1954. Since only one patient in 300 or more has an identical twin available—let alone willing—to donate a kidney, researchers in a dozen branches of medical science have been trying ever since to devise a way of switching off the immune or rejection mechanism long enough to let a transplant "take," then restore it so that the recipient will not be a helpless prey to every passing infection.
Research doctors have had some, but by no means complete, success with X rays, and with two classes of drugs—the anti-cancer chemicals and cortisonetype hormones. They have devised increasingly complex methods of matching white blood cells to reduce antibody formation, and of making antilymphocyte serum in horses to reduce the white cells' activity. This partial success has been sufficient to give today's recipient of a kidney transplant (from close kin or even an unrelated cadaver) at least a 65% chance of surviving.
Every normal person has two kidneys, and since he can live on one, that means he has one to spare. The corpses of healthy people killed in accidents provide two. So although the demand still far exceeds the supply, the kidney transplanter's problem is minor compared with that of the surgeon who would transplant a liver. Each man has only one, and cannot live without it. The world's pioneer in transplanting livers, Dr. Thomas Starzl of the University of Colorado, has obtained 15 so far, with encouraging results in four recent operations on little girls (TIME, Dec. 1). Comparable problems of supply confront the University of Minnesota's Dr. Richard C. Lillehei, who has transplanted the pancreas with duodenum attached, and an almost complete intestinal tract.